• Yu-Hua Huang and Chien-Yu Ou.
• Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Neurosurgery, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan.
• World Neurosurg. 2015 Sep 1; 84 (3): 780-5.

ObjectiveLumbar fusion is a widely used procedure for degenerative spine diseases but frequently is accompanied with substantial surgical blood loss. We aimed to investigate the risk factors for significant intraoperative blood loss and the influence of excessive bleeding on postoperative complications in patients undergoing fusion for degenerative lumbar spines.MethodsFor this retrospective study, we enrolled 199 patients who had undergone lumbar fusion surgery for degeneration. The definition of significant blood loss at operation was 500 mL or more in blood volume. The patients were subdivided into 2 groups on the basis of whether significant blood loss was present (n = 107) or not (n = 92).ResultsThe incidence of significant blood loss during lumbar fusion was 53.8%. In the multivariate logistic regression model, the independent risk factors for significant blood loss included body mass index (P = 0.027), extreme spinal canal narrowing (P = 0.023), spine fusion segments >1 level (P = 0.008), and transforaminal lumbar interbody fusion (P = 0.006). Significant blood loss in lumbar fusion was associated with a greater incidence of postoperative complications (P = 0.002). The length of hospital stay for patents with excessive bleeding was prolonged significantly (P = 0.045).ConclusionsBecause substantial bleeding in lumbar fusion is associated with a greater incidence of morbidities and prolonged length of hospital stay, attention to the risk factors for significant blood loss is important in the preoperative assessment and postoperative guidance for the level of care.Copyright © 2015 Elsevier Inc. All rights reserved.

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